Consumption of ayahuasca by children and pregnant
women: medical controversies and religious
perspectives.

Abstract:

In 2010, the Brazilian Government agency responsible for
drug-related issues formulated official Resolutions that categorized the
consumption of ayahuasca by pregnant women and children in the Santo
Daime and Uniao do Vegetal ayahuasca-based religions as an
"exercise of parental rights." Although ayahuasca groups do
enjoy a relative degree of social legitimacy and formal legal
recognition in Brazil, the participation of pregnant women and children
nevertheless continues to provoke heated discussion. This article raises
the main issues involved in the public debate over this subject. In the
first part, a diverse group of biomedical and health specialists was
consulted, and their opinions were briefly analyzed. In the second, a
full interview with a follower of one branch of Santo Daime, mother of
four children who took ayahuasca during all her pregnancies, and whose
children all drink ayahuasca, is presented. Her interview reveals
important cultural parameters of ayahuasca consumption. The article
explores common themes and contradictions found between the biomedical,
anthropological, and ayahuasca-users' discourses. It raises central
issues regarding the limits of freedom of religion and the state's
right to interfere in family matters. The following analysis also has
implications regarding the role of science in influencing policy
decisions on drug use.

Ayahuasca, also known as daime, hoasca, or vegetal, is a
psychoactive mixture made from the Amazonian plants Banisteriopsis caapi
and Psychotria viridis and contains dimethyltryptamine (DMT), a
controlled substance subject to international drug laws. The brew is
used in religious and shamanic rituals by Amazonian indigenous groups as
well as by urban religions based in Brazil, notably Santo Daime and
Uniao do Vegetal (UDV) (for a discussion of the concept of ayahuasca
religions, see Labate, MacRae & Goulart 2010; for a broader
reference on this phenomenon see Labate, Rose & Santos 2009; Goulart
2004; Labate & Araujo 2004; MacRae 1992). A cover article from the
Brazilian magazine Isto E, which is the third-highest selling weekly
magazine in Brazil, recently reignited a heated discussion about the
consumption of ayahuasca by pregnant women and children. The article,
entitled "A Encruzilhada do Daime" (a play on words that means
both "the Daime crossroads" and "the Daime
deadlock"), claims that "the use of ayahuasca by pregnant
women is dangerous ... it is believed that it can provoke neurological
alterations in the fetus ... and for the same reason should not be
consumed by children" (Gomes 2010: 73). The journalist credits
these claims to two psychiatrists, Dartiu Xavier da Silveira and Jaime
Hallak. At about the same time, National Geographic aired a series
called Taboo of which one episode, entitled "Narcotics"
(Valenti 2010), included a segment filmed at the Santo Daime religious
community of Centro Ecletico da Flor de Lotus Iluminado (CEFLI [The
Eclectic Center of the Illuminated Lotus Flower]) in the Brazilian state
of Acre. The fifteen-minute segment emphasized the consumption of
ayahuasca by infants and children, repeatedly showing close-ups and
scenes of this activity. It is apparent that even if the ayahuasca
religions currently enjoy a relative degree of social legitimacy and
actual formal legal recognition in Brazil, the participation of pregnant
women, children and adolescents continues to dominate public debate and
is frequently used to question the validity of the use of ayahuasca in
general (Labate 2005).

Very little is known about this subject. From the human sciences
literature, there are only a few mentions of ayahuasca use by pregnant
women and children: one short personal anecdote about ayahuasca use
during childbirth published in the appendix of Vera Froes
Fernandes's (1986) seminal book on Santo Daime; an interview with a
professional midwife from the Ceu do Mapia community, the headquarters
of one branch of Santo Daime religion in the Amazon interior (Monteiro
2004); and a brief reference to the frequency with which youths of
different ages are permitted to consume ayahuasca in the Uniao do
Vegetal church. According to the latter source, children less than
twelve may participate in no more than five rituals per year; from
twelve to fourteen years of age, they are allowed to consume once a
month; from fourteen to eighteen, twice a month; and over eighteen, they
may become full members of the church. (Soares & Moura In press).
From the biomedical point of view, only one study is known. This focused
on 40 adolescents from UDV, and their results were published in a
special edition of the Journal of Psychoactive Drugs, "Ayahuasca in
Cross-Cultural Perspective," edited by Marlene Dobkin de Rios and
Charles Grob in 2005. The editors' introduction mentions the use of
ayahuasca by pregnant women (Dobkin de Rios & Grob 2005a: 119) but
no further information was given.

The current article raises the main issues involved in the public
debate over ayahuasca use by pregnant women and minors in Brazil. The
controversies surrounding this aspect of ayahuasca use highlight the
conflicting discourses between anthropologists, the biomedical field,
media, ayahuasca users and leaders of other religious denominations.
This article presents a history of the regulation of the use of
ayahuasca for pregnant woman and children in Brazil, and references
relevant biomedical and social science research, as well as native
religious perspectives. It serves as an anthropological comment on the
topic, pointing out the contradictions and continuities between the
different perspectives, and the difficulty in establishing a dialogue
between them. First, a diverse group of biomedical and health
specialists was consulted, and their opinions are presented. Note that
only specialists directly involved in research on ayahuasca and its uses
and effects were interviewed, which resulted in a very select group. The
field of debate on psychoactive substances is broad and very polarized,
so more diverse and more extreme opinions certainly exist. However, it
was possible to identify a variety of perspectives inside this field.
Following this is an attempt to briefly analyze these discourses and
predict possible outcomes for policy making which result from these
approaches.

In the second part, given the paucity of published ethnographic
information on this aspect of ayahuasca use, the full text of an
interview with a follower of one branch of Santo Daime is provided. I
have chosen to interview one person at length, rather than provide
several briefer interviews of less depth. This person is of particular
interest because she is both a professional involved in perinatal
activities and also has had profound personal experiences with ayahuasca
herself. In this interview some of the cultural parameters of the use of
ayahuasca by pregnant woman and children in the context of Santo Daime
are revealed.

Those interviewed for this study were informed of the purpose of
this anthropological study and consented to be interviewed and quoted by
name. One subject asked to be quoted anonymously.

REGULATION OF THE USE OF AYAHUASCA BY PREGNANT WOMAN AND CHILDREN

During the mid-1980s, the ritual and religious use of ayahuasca was
regulated in Brazil through a process of negotiations between the
government, scientists and representatives of ayahuasca-using groups.
This process has gone through various stages since then and continues to
develop (MacRae 2010, 2008, 1992; Labate 2005). At the broadest level,
what was at stake here was a dispute between laws concerning the use of
controlled substances, such as the DMT found in ayahuasca, and the right
to religious freedom. In contemporary Brazil, the latter has trumped the
former. Until 2004, the legal right of children and pregnant women to
use ayahuasca was nevertheless uncertain.

In 2004, Resolution No. 5 of Conselho Nacional de Politicas sobre
Drogas (CONAD, [National Council on Policies about Drugs]), the
government agency responsible for drug-related issues, drawing on the
article 1.634 of the Brazilian Civil Code, interpreted the right of
pregnant women and children to consume ayahuasca as falling under the
domain of the "exercise of parental rights." Parental rights
are, "a parent's rights to make all decisions concerning his
or her child, including the right to determine the child's care and
custody, the right to educate and discipline the child, and the right to
control the child's earnings and property" (Garner 2004:
1146). However, it is important to remember the state's right to
interfere in cases of abuse or noncompliance with legal
responsibilities, which balances parental authority.

The CONAD 2004 Resolution also cites article 14 of the Convencao
Sobre os Direitos da Crianca (Convention on the Rights of Children),
ratified by Brazil and promulgated by Decree No. 99.710 on November 21,
1990. Resolution 5 was supported by the Parecer da Camara de
Assessoramento Tecnico-Cientifico Sobre o Uso Religioso da Ayahuasca
(Report of the Technical and Scientific Advisory Board about the
Religious Use of Ayahuasca), a report produced about three months before
by experts to provide CONAD with scientific, scholarly, and technical
advice for the elaboration of its future ayahuasca policies (Camara de
Assessoramento Tecnico-Cientifico 2004). This text further cites the
Estatuto da Crianca e do Adolescente [Statute of Children and
Adolescents], Law No. 8.069, 13 July, 1990, which includes freedom of
religious belief and practice in its interpretation of the rights of
children and adolescents (Article 16, III; also Article 58).

46. Keeping in mind the lack of sufficient scientific evidence and
that Ayahuasca has been used for centuries and has not shown damaging
health effects, and considering the terms of CONAD Resolution 05/04, the
use of Ayahuasca by minors under 18 (eighteen) years old is left up to
the deliberation of the parents or legal guardians, within the domain of
adequate exercise of parental rights (article 1634 of the Civil Code);
and with reference to pregnant women, they themselves assume the
responsibility for deciding the degree of their participation, always
attentive to protecting the development and personality structure of
their underage and unborn children.

BIOMEDICAL STUDIES

I have found no mention of biomedical research on the effects of
ayahuasca use on pregnant women or unborn fetuses. On a prior version of
the official website of the Uniao do Vegetal (2007), the following
information was provided concerning a research project underway called
Efeitos da Hoasca na Gestacao (Effects of Ayahuasca during Pregnancy):

With the goal of studying the effects of ayahuasca tea on pregnancy
and the development of children born to mothers who used ayahuasca
during pregnancy, a group of health professionals from UDV's
Medical-Scientific Department (DEMEC) carried out a retrospective pilot
study in the city of Fortaleza, Ceara. Using interviews, questionnaires
and tests, they attempted to identify the occurrence of obstetric
pathologies in such pregnancies, and evaluate the neuropsychological
development of children born to such pregnancies. The results require
critical methodological evaluation and statistical study sufficient for
publication. [author's translation from Portuguese]

It was not possible to obtain further information about the
progress of this research, however, and the notice has since been
removed from the UDV website.

Only one published study on young consumers of ayahuasca is known.
It was carried out by an international consortium of researchers who
evaluated 40 adolescents from UDV in three different cities in Brazil,
and compared them with a matched control group of 40 non-ayahuasca using
adolescents (da Silveira et al. 2005; Dobkin de Rios & Grob 2005a,
2005b; Dobkin de Rios et al. 2005; Doering-Silveira et al. 2005a,
2005b). Overall, the UDV adolescents showed similar results to the
control group on most neuropsychological and psychiatric tests applied.
One of the researchers, Dartiu Xavier da Silveira, a psychiatrist at the
Programa de Atendimento e Orientacao a Dependentes (PROAD [Program for
Orientation and Assistance to Dependents]) of the Universidade Federal
de Sao Paulo (UNIFESP [Federal University of Sao Paulo]), was quoted in
the polemical Brazilian magazine piece mentioned in the introduction. In
an email sent to the author on February 21, 2010, when asked about his
thoughts concerning the consumption of ayahuasca by children and
pregnant women, he responded,

No scientific studies have proven that ayahuasca is harmful during
pregnancy. We can take other psychoactive substances as
counter-examples. Alcohol, for example, we now know, is absolutely
contraindicated during pregnancy, even in small quantities, for the risk
of fetal alcohol syndrome. Despite this, we have reports of many people
who drank alcohol during pregnancy and nothing happened to their
children--which doesn't change our knowledge that something could
have happened due to alcohol consumption. In the case of ayahuasca, we
carried out research with adolescents in UDV and found no significant
differences between them and a control group of nonconsumers of
ayahuasca. However, more research is needed. Scientific rationality is
very different from common sense. [author's translation from
Portuguese]

Charles Grob, coauthor of this and other important studies on
ayahuasca (Callaway & Grob 1998; Callaway et al. 2006, 1999, 1996,
1994; Grob et al 1996; McKenna, Callaway & Grob 1998) was also
consulted. Grob is professor of psychiatry and pediatrics at the medical
school of the University of California, Los Angeles and director of the
Division of Child and Adolescent Psychiatry at the Harbor UCLA-Medical
Center. In an email sent to the author on February 19, 2010, he stated
that,

Another researcher cited in the Isto E piece is Jaime Hallak, a
psychiatrist at the Departamento de Neurociencias e Ciencias do
Comportamento (Department of Neurosciences and Behavioral Sciences) at
the Faculdade de Medicina de Ribeirao Preto (Ribeirao Preto Medical
Faculty in Sao Paulo state). His research team has studied the potential
antidepressant effects of harmine, a beta-carboline alkaloid found in
the ayahuasca brew, by injecting the substance into laboratory animals
(Fortunato et al. 2009, 2010). In an email sent to the author on
February 23, 2010, he expressed his view that:

In an email sent to the author on February 26, 2010 biologist
Rafael Guimaraes dos Santos, who is carrying out doctoral research on
the human pharmacology of ayahuasca at Hospital de la Santa Creu i Sant
Pau (Hospital of the Holy Cross and Saint Paul) in Barcelona (Santos
2007; Santos & Strassman 2008; Santos et al. 2007; Santos, Moraes
& Holanda 2006), stated his opinion:

I know of only one study carried out with adolescents of Uniao do
Vegetal. It demonstrates that there is no scientific evidence that
ayahuasca use in this context by this religious group produces
psychiatric, neuropsychological or substance abuse problems. Most of the
adolescents in the study have been exposed to ayahuasca since the
prenatal period and throughout childhood. In the case of Santo Daime and
Barquinha (another Brazilian ayahuasca religion), there are no published
studies. Thus, from a scientific perspective, the available information
is limited. On the other hand, there is evidence that some of the
beta-carbolines present in ayahuasca, for example harmine, show toxic
effects in some preclinical studies. But we do not yet understand the
implications of this for human consumption of ayahuasca. Personally, I
believe that ayahuasca use by pregnant women and children should be
extremely limited to small and infrequent doses. [author's
translation from Portuguese]

In an email sent to the author on February 26, 2010, a German
specialist in the pharmacology of psychoactive substances who chose not
to be identified by name in this article said:

A central theme in all of these commentaries is an oscillation
between what might be called in common parlance viewing the glass as
half empty or as half full, which is to say, the various researchers
interpret the same fact in different ways. The two lines of reasoning
might be summed up as follows: (1) There are no studies showing that
ayahuasca use by pregnant women and children is innocuous, and (2) There
are no studies proving it is harmful. Proponents of the former appear to
assume that psychoactive substances are "guilty until proven
innocent," as it were, while the latter takes a more agnostic
stance, suggesting it is up to scientists to do more research to
determine these results.

The problem here involves linking scientific knowledge and
practical action. Although most of those interviewed appear to assume
that their research should provide a scientific basis for public
policies, they stop short of expressing explicit political views.
However, the news media, activists, judges, and politicians exploit both
the "half empty" and "half full" opinions for a
variety of purposes. The former ultimately lends ammunition, directly or
indirectly, to those who would like to see ayahuasca use, at least in
certain circumstances, either prohibited, suspended or, at the very
least, treated with extreme caution until more research can be done. The
onus would appear to fall on the users themselves to prove that
ayahuasca is not harmful. The more or less explicit implications of the
other branch, the "half full" attitude, are that, in the
absence of contrary evidence, use should continue to be permitted,
albeit with caution, while more studies are carried out. Here, the onus
would appear to fall on the state to provide solid evidence, whether
from scientific studies or reports concerning problems among users, that
use is harmful before any modification to the current, permissive
regulation should be made. Despite the differences, both perspectives
agree on the need for precaution and further study.

RELIGIOUS PERSPECTIVES

Legal decisions regarding the use of ayahuasca are not only subject
to the outcomes of biomedical discussions, they require an
interdisciplinary approach which includes anthropological discussion and
the perspectives of users themselves, among other possible points of
view. Seeking to understand the context of ayahuasca use by pregnant
mothers and children in Santo Daime, a series of interviews were
conducted with Clarice Andreozzi through emails to the author between
February 17 and March 4, 2010. Andreozzi is a 34-year-old biologist born
in Brasilia who is a practicing doula, a profession akin to midwifery
dedicated to the emotional and physical management of pregnancy and
childbirth. She belongs to the Ceu do Planalto church in Brasilia, part
of the Igreja do Culto Ecletico da Fluente Luz Universal Patrono
Sebastiao Mota de Melo (ICEFLU [Eclectic Church of Universal Flowing
Light of Patron Sebasitao Mota de Melo]), formerly the Centro Ecletico
da Fluente Luz Universal Raimundo Irineu Serra (CEFLURIS [Eclectic
Center of Universal Flowing Light of Raimundo Irineu Serra]) tradition
within Santo Daime. For her, ayahuasca consumption takes place within a
profoundly meaningful network of belief and practice.

BCL: Could you tell me about your professional background?

CA: I graduated in biological sciences from the Universidade
Catolica de Brasilia (Catholic University of Brasilia). For my
bachelor's thesis I analyzed the physiology of childbirth, a
relatively new and little-explored field. I studied the hormones
involved in labor, childbirth and the immediate post-partum phase, and
the conditions necessary for childbirth to proceed normally. I practice
as a doula and peri-natal educator. I did professional training in Sao
Paulo with the 'Support Group for Active Maternity' (Grupo de
Apoio a Maternidade Ativa [GAMA]). I work with pregnant women, give
courses to prepare them for birthing, and accompany women during labor
and childbirth.

BCL: And could you now tell me about your involvement with Santo
Daime.

CA: I came to Santo Daime at thirteen years old; actually, it was
just before my fourteenth birthday, which I celebrated at the church
during their commemoration of Saint Peter's day (June 28, 1989). My
mother had been in the church about a year and so she took us; me and my
sisters. For me, my identification with this church was totally
innocent; it was all new to me. I went through lots of powerful,
difficult moments ("passagens"), because, of course, I had no
experience with psychoactives. But I never again left it. Santo Daime
fascinated me, and continues to fascinate me.

BCL: In the context of Santo Daime, do pregnant women take Daime?
What dose, and with what frequency? Is it customary to take Daime during
labor and childbirth?

CA: Yes, women can take Daime during the whole period of pregnancy
and also during labor. It is the woman's own choice, no one forces
it on her. As is the case with children, pregnant women take a smaller
dose than the adults. We usually give half the usual dose, but if they
want less than that, they can drink less. They can participate in all
the rituals as they wish, there is no restriction but also no obligation
to participate, it is a personal decision. It is common for women
members of the church to take Daime during labor. The beverage itself as
well as the prayers are good for childbirth, they help the woman relax
and maintain contractions. In some cases it can even increase the
contractions, which is good, because they are natural and healthy
contractions which allow her to experience the pregnancy and contact
with the baby, to interiorize the experience more profoundly. The dose
of Daime during childbirth is also small, and varies according to the
duration and intensity of labor. We should remember that Mapia, in
Pauini, Amazonas, has a very strong tradition of childbirth with Daime,
more so than in the cities. In the big cities, Daime is used less during
childbirth and less for medicinal purposes more generally, because here
we have access to public health services and pharmacies. But out in the
forest people turn to Daime, for example when babies have colic or
constipation; or when babies get colds they give them home-made syrup
with a little Daime to clear the mucus.

BCL: Do children take Daime? From what age?

CA: Children do take Daime, but there is not a specific age to
begin drinking the beverage, nor is it obligatory. It is a decision left
entirely up to the parents. We have a doctrine, and for us, Daime has a
whole lot of meaning, as you know. But every family has its own way of
approaching this question. Some parents give Daime to their children,
and others prefer not to. We respect the family life of everyone, and
there is no requirement that parents give Daime to their children. Some
parents give Daime to their newborn children right after birth, as a
kind of baptism. In addition, we have a formal baptism ritual, which
happens during the "hymnal" days (ritual sessions during which
people wear white uniforms and sing and dance for many hours). There is
a specific moment for baptism, when those responsible for the household
or someone they delegate carries out the ceremony. It is a simple and
quick ritual, in which the child is baptized with water, salt and Daime.
During the baptism, everyone present utters the Lord's Prayer,
"Hail Mary" and "Hail holy Queen." I think most
Santo Daime followers baptize their children in this way, and some
baptize them in the Catholic Church as well. During infancy and
childhood, the parents give Daime to children only if they seem
interested or ask to take it. Children generally take Daime during
hymnal days or when there are specific sessions for children.

BCL: What are the children's sessions like? What is the
dosage?

CA: The children's session is very brief, about an hour; we
sing children's hymns, hymns about children. These are easier to
sing. For example, we have one called "Little Yellow Bird" :

Another children's hymn we sing a lot in Brasilia is
"One, Two, Three":

During these sessions we also tell Biblical stories. We teach the
children to sing and play the rattle, and those who show talent are
taught other instruments as well. We see this like a spiritual school, a
catechism, where we teach our children the values of fraternity,
justice, love and peace. The dose for children is small but increases as
they grow. Babies take Daime by the drop, which we squeeze into their
mouths with cotton balls. Infants of one to three years old drink just
the dregs from the bottom of the glass, I doubt it's even one
milliliter. The dose is increased as the child grows older. By thirteen
or fourteen, youths can take as much as one-third the adult dose, if
they want. If not, they can take less. In fact it's up to the
children to indicate their interest in participating in the spiritual
sessions.

BCL: Do you have children?

CA : Yes, I have four children, three sons and a daughter, ages
five, thirteen, fourteen and sixteen. They were all raised within the
Santo Daime doctrine. They all had the freedom to choose. They only go
to the sessions and commune with Daime if they want. My children are
excellent students, they get good grades and I've had no complaints
from teachers about discipline, participation or any other problems.
They are well behaved and sociable children. Of course they all have the
usual problems that come with each different age, but that's
normal.

BCL: Did you take Daime during childbirth? How was it?

CA: I took Daime during all my pregnancies and during childbirth.
All of the births were normal, without complications. Daime gave me a
full consciousness about my body and what was happening during such a
special moment as childbirth. I was able to relax and experience the
births in a very beautiful and positive manner. Despite the normal
birthing pains, I felt comfortable and completely certain about what was
happening, and felt a deep understanding about the meaning of birth and
motherhood. All of the births went really well, but I'd like to
tell you about the second one, since for almost the whole time I was in
a Santo Daime session. It was on Saint Anthony's Day, we always
celebrate the night before (12-13 June). I spent the night in a hymnal
session, singing and dancing with everyone else. After the ritual was
over, I went into labor. It was a very fast and peaceful process, there
was just barely enough time to get to the hospital.

BCL: Do you give Daime to your children?

CA : Yes, they all take it if they want. My daughter, the oldest,
loves to take Daime, she almost takes it more than I do! She took it for
the first time just five hours after being born, just a drop. Like I
said before, because we believe that this protects the child. Sometimes,
when we have a spiritual session on a weekday, I insist that she not
participate, since the next day she has school, and I don't want
her to be tired at school (sometimes the sessions go on until late). My
eldest son also likes to go to the sessions, but he is very sensitive to
the effects, so he takes very little Daime, less than 3 ml. He also took
a few drops of Daime soon after being born. Because he is more
sensitive, both I and he himself are especially careful that he not take
too much. My thirteen-year old son doesn't like it and doesn't
go often to the sessions, so I don't insist, and he only goes when
he wants to. The five-year old, however, really likes to go. If I let
him he would go all the time, but he's still too young, he only
goes to hymnal sessions that take place during the day, and to the
children's sessions. He also takes a very small dose, 2.5 ml at
most. I've given it to him a few times when he had bad
constipation, it cured the problem. Another time he was really agitated
and couldn't sleep, so I gave him a little Daime and soon he calmed
down and went to sleep.

BCL: How would you react to the following statement, "The use
of ayahuasca by pregnant women is dangerous. It is thought that it can
provoke neurological changes in the fetus. For the same reason it should
not be taken by children"?

CA: I would ignore these assertions. It is a frivolous claim at the
very least, with no scientific support or evidence. Daime gives women a
profound experience of pregnancy and a strong contact with the baby in
her womb [cf. Schaefer In press for a similar description by Huichol
women about peyote use during pregnancy]. And children who take Daime
are normal, healthy and intelligent. At this point there are many
families who have used Daime in the church for several generations, and
in general they are healthy, happy, prosperous and well-balanced. Daime
is part of our religion, and people outside find it difficult to
understand. Unfortunately, there is still a great deal of prejudice
about our doctrine.

BCL: What do you think about the Brazilian government's
legalization of ayahuasca use by children and pregnant women?

CA: It is fundamental. A hard fought and justly earned right, the
right to religious freedom. Daime isn't just some hallucinogen. It
is a profound part of our beliefs, our doctrine. It is only taken during
our spiritual sessions. The person who takes Daime believes in its
spiritual power, believes in the benefits it brings. For Santo Daime
practitioners, it is a sacrament, that's why we say "commune
with Daime" (comungar Daime). To deny or prohibit its use would be
arbitrary at the very least.

CONCLUDING REMARKS

This article has explored some of the common themes and
contradictions found between various discourses, including those of
scientists and ayahuasca users, surrounding consumption of ayahuasca by
children and pregnant women. The anthropological literature has
described the ritual and religious contexts and detailed the behavioral,
dietary and ethical prescriptions expected of practitioners of religious
groups such as Santo Daime and Uniao do Vegetal (Goulart 2004; Labate
2004; MacRae 1992). The existing literature has also pointed to the
strict controls surrounding access to the beverage, particularly in
terms of dosage and frequency. In the context of these religions, dosage
is generally determined by age, weight, gender and experience within the
group, as well as according to specific health and psychological
conditions gleaned through ongoing evaluation and observation of
participants within and outside the ritual setting (Labate 2009; MacRae
1992). The interview with Clarice Andreozzi highlights how the same
factors come to play in the use of ayahuasca by children and pregnant
women in the Santo Daime tradition. Ayahuasca use is not free or loose;
rather, it takes place within specified ritual, cultural and religious
parameters that provide strong control mechanisms.

The CONAD resolutions that govern the use of ayahuasca in Brazil
for both adults and children resulted from a dialog between biomedical,
social science and native perspectives. It recognizes, among other
things, that users have important and valuable empirical knowledge about
ayahuasca through accumulated use and experience. The most recent CONAD
resolution, while respecting the practices and knowledge of ayahuasca
religions, also calls for further research on these and other aspects of
ayahuasca use (CONAD 2010). Building on the preliminary studies
mentioned here (da Silveira et al. 2005; Dobkin de Rios & Grob
2005a, b; Dobkin de Rios et al. 2005; Doering-Silveira et al. 2005a, b),
more research of an interdisciplinary nature is required to evaluate
short-term and long-term cognitive effects of ayahuasca use in children.
Studies of pregnant women and children could be done using research
designs similar to that which were used to study teenagers in the UDV.
Controlled-matched cohort studies of UDV or Santo Daime children could
be done as they grow up within the religions. These studies would
ideally have a developmental focus, taking into account the duration and
frequency with which the children and their pregnant mothers
participated in the rituals. It would also be helpful to distinguish
between the findings seen in adult members of UDV and Santo Daime and
those in other ayahuasca-using contexts who started consuming ayahuasca
and attending rituals at different periods (i.e. in utero, infancy,
childhood, adolescence, adulthood), focusing on central stages of
neurodevelopment. Finally, experimental research could be done in which
ayahuasca is administered in shamanic, religious or therapeutic contexts
or to other populations without previous experience with ayahuasca and
the harms and benefits could be evaluated. These studies on children and
pregnant woman would have to be approved by university ethical review
committees; in any case, this research would involve great ethical,
legal, methodological and funding challenges.

Important avenues for more social science research include studying
how the consumption of ayahuasca by pregnant woman and children is
important for building religious and cultural identity within these
groups, and also how the religious minority status of ayahuasca users
comes to play out in the definition and expression this identity.
Researchers in the field of anthropology of science should examine how
biomedical research is constructed, and look at how doctors, judges,
journalists and religious leaders translate the rodent physiology to
human physiology and use rodent data to estimate human health risks. It
is also important to do an "ethnography of power" to
understand how different social agents mediate access to and influence
the formulation of public policies on the use of ayahuasca. It is of
special relevance to study how biomedical discourses tend to receive
greater weight in public debates than other discourses, such as those in
the social sciences and religion, and also to analyze biomedical
science's role in the context of legal cases involving the use this
substance.

Furthermore, social science research should compare the use of
ayahuasca by children and pregnant woman with the use of other
substances such as alcohol and tobacco, where the ill effects for
pregnant women, fetuses and children have been clearly documented, and
where laws and public health campaigns have been designed to limit, if
not prohibit outright, their consumption among certain categories of
people. This, in turn, raises the broader issue of the legal, historical
and moral roots of the prohibitionist laws and educational campaigns
that hope to "save our children from drugs." This article has
been limited to a few cases related to several of these discourses.
Future research should extend the range of social agents and those with
differing perspectives seen as stakeholders in the current debate.

The case of ayahuasca, as we have seen, raises important questions
about the rights of religious minorities, and how these rights fit
within the questions concerning controlled substances more generally. On
one side, there are the parental rights to determine what constitutes
appropriate upbringing of children, which would include religion,
education, and the consumption of foods, medicines and psychoactive
drugs. On the other side are those that claim children have the right
not to receive religious indoctrination or certain psychoactive drugs.
These decisions should be based on extending both our empirical, social
and biomedical knowledge on the subject, as well as broader
philosophical and ethical reflections on human rights. I hope to have
called attention to the richness of this field of inquiry that remains
so unexplored.

([dagger]) This article was translated from the Portuguese by Glenn
H. Shepard Jr., and revised by Clancy Cavnar.

Beatriz Caiuby Labate, Ph.D., Anthropologist, Research Associate at
the Institute of Medical Psychology at Heidelberg University, Member of
the Collaborative Research Center (SFB 619) "Ritual
Dynamics--Socio-Cultural Processes from a Historical and Culturally
Comparative Perspective" and researcher at the Interdisciplinary
Group for Psychoactive Studies (NEIP).

Along with colleagues from the United States, Finland, and Brazil I
conducted a series of biomedical-psychiatric research studies on
the effects of hoasca in subjects who were members of the syncretic
religion Uniao do Vegetal. In 1993 we studied long-term adult
members of the UDV and in 2001 we studied adolescents who came from
families who were affiliated with the UDV. Our findings have been
published in the mainstream psychiatric and neuroscience
literatures. Our research investigation of the effects of hoasca on
adolescents contrasted their psychological function with a matched
non-hoasca using adolescent control population. In our study we
found that these young people from UDV families, many of whom had
been exposed in-utero to hoasca and who had been baptized as
infants with a very small quantity of hoasca, were allowed to
participate in UDV religious ceremonies where hoasca is used as a
psychoactive sacrament after reaching puberty. Participation in
ceremonies and ingestion of hoasca by adolescents was entirely
optional and left to the adolescent to decide. The results of our
investigation revealed that the adolescents from UDV families who
participated in hoasca ceremonies were in very good psychological
health. In fact, the hoasca-exposed adolescents reported lower
rates of alcohol and substance use than the non-hoasca exposed
control adolescents as well as overall lower levels of anxiety.
Their neuropsychological function was evaluated as normal. In
conclusion, we detected no evidence that hoasca use had caused any
injurious effects in adolescents from the UDV who had been exposed
to hoasca.

... lacking any evidence about safety and/or risk, the consumption
of ayahuasca should be avoided by pregnant women
until safety evidence exists. I know of several groups who are
carrying out studies of safety and toxicity to evaluate such
aspects, but their evaluations are not yet complete, including
those of our own group.

After reviewing all of the pharmacological and clinical
studies--more than 500 scientific publications over the past ten
years--on DMT and 5-methoxy-DMT (a substance similar to
DMT that is sometimes found in the ayahuasca mixture), it can
be asserted that not a single study exists, either in animals or
humans, that examines the teratogenic, embryotoxic or uterotonic
effects of DMT or 5-MeO-DMT. So we know nothing
about (potential) risks. However, we must realize that DMT
is naturally present in the body, so it is very unlikely that it
destroys parts of an organism, unless used in overdose. There
is also no evidence of children with mutations or disabilities
as a result of the mother's consumption of ayahuasca during
pregnancy. What we do know is that psilocybin, a derivative
of DMT, produces some minor chromosome aberrations (cf.
Eberle & Leuner 1970), even when used in small doses (see
also Pahnke et al. 1970; Grof 1980; Passie et al. 2008). But
these mutations occur in doses equivalent to those which can
be caused by aspirin or coffee, which are normally considered
harmless even for pregnant women. However it is possible to
imagine that this would present a risk to the baby only during
labor and birthing, and not the pregnancy per se.
In sum, we do not know much, but there is no documented
evidence of a pregnant woman or child who has suffered
any harm due to DMT/5-MeO-DMT. But we have to mention
other aspects. There are many other substances present
in ayahuasca preparations. These other substances, especially
harmala alkaloids, have not been well studied to date. In reality,
we don't know anything about all the substances present
in these beverages. It could also be dangerous to a fetus if
a pregnant woman consuming ayahuasca vomited or became
extremely frightened. But again, it could also be true that the
woman has very positive experiences. I would conclude by
saying that it is not possible to assert that taking ayahuasca
causes harm to children or pregnant women, because there is
no evidence (either experimental or among actual mothers and
children) on the matter. However we should be cautious. We
need to have more research to provide definitive evidence.

Little yellow bird flying alone
I have company night and day
I have the sun and the stars and baby Jesus
Baby Jesus lives in my heart
He shines in the air I breathe
Glitters in this vastness

One, two, three
Four, five, six
Seven, eight, nine
God is here
He is peace, He is harmony
He is the Lord
Of sovereignty
Now I ask for peace
From my Lord Saint John
Now I ask for a blessing
From Father Sebastian